Short‐term cross‐over studies indicate that airway clearance approaches might benefit patients with cystic fibrosis (CF) by improving mucus transport, a Cochrane review has concluded.

However, the evidence was limited and reviewers found no “robust scientific evidence to support the hypothesis that airway clearance techniques have a long‐term beneficial effect in people with CF, nor to support the claim by some authors that these interventions are harmful”.

The review (line here) included 12 randomised or quasi-randomised studies involving 194 patients with cystic fibrosis that compared the impact of airway clearance techniques (chest physiotherapy) compared to none or spontaneous cough.

Current data provides “limited evidence of a short‐term impact on lung function”, but that “methods of clearing the airways may have short‐term benefits for moving mucus”, but certainty of the evidence was low or very low, the reviewers said.

Four of the studies concluded that airway clearance techniques resulted in increased sputum production, although one found no difference in patients who used the intervention or not.

Also, five studies showed increased radioactive tracer clearance with airway clearance techniques, while one assessing positive expiratory pressure showed no difference, they noted.

Notably, none of the studies assessed the impact of airway clearance techniques in people treated with CFTR modulator treatments.

As such, “further research is needed to determine the effectiveness and acceptability of airway clearance in those treated with highly effective CFTR modulators,” the reviewers concluded.